• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.12-25
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• 2003

Objectives：As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods：Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results：1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion：Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1124-1139
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• 2021

The objective assessment of atrophy and the measurement of brain volume is important in the early diagnosis of dementia and neurodegenerative diseases. Recently, several MR-based volumetry software have been developed. For their clinical application, several issues arise, including the standardization of image acquisition and their validation of software. Additionally, it is important to highlight the diagnostic performance of the volumetry software based on expert opinions. We instituted a task force within the Korean Society of Neuroradiology to develop guidelines for the clinical use of MR-based brain volumetry software. In this review, we introduce the commercially available software and compare their diagnostic performances. We suggest the need for a standard protocol for image acquisition, the validation of the software, and evaluations of the limitations of the software related to clinical practice. We present recommendations for the clinical applications of commercially available software for volumetry based on the expert opinions of the Korean Society of Neuroradiology.

• Journal of Acupuncture Research
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• v.27 no.1
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• pp.51-64
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• 2010

Objectives : To introduce and compare various headache measurement tools, in order to provide fundamental information for future clinical trials and development of oriental medicine measurement tools. Methods : Eight headache assessment scales, Migraine-Specific Quality of Life Questionnaire(MQoLQ), Migraine-Specific Quality of Life(MSQOL), Migraine-Specific Quality of Life Questionnaire(MSQ), The Headache Impact Questionnaire(HImQ), Headcahe Needs Assessment Survey(HANA), Henry Ford Headache disability Inventory(HDI), Migraine Disablity Assessment Scale(MIDAS) and Headache Impact Test(HIT-6), were searched through Pubmed. General character, the process of development, verification of reliability, internal consistency, responsiveness to patient's change and validity were reviewed. Results : In assessing the quality of life of migraine patients, MQoLQ can be used to measure the change within 24 hours, MSQ and MSQOL can be used to measure the change during a relatively longer period of time. The frequency and bothersomeness of headache can be easily measured by HANA. HImQ can be used to measure the intensity of headache and the influence on normal daily activities. HDI can measure the emotional difficulties of headache patients. HIT-6 and MIDAS makes measurements possible in a short period of time, and the reliability and validity have been verified numerously. HIT-6 and MIDAS are the most frequently used measurement tools because they are simple and easy for both the assessor and the patient to understand and use. Conclusions : In this study, various headache assessment tools have been reviewed. The assessed tools were widely used after being verified for their reliability and validity. We hope this study provides fundamental information in establishing future clinical trial and clinical practice guidelines. We also hope this study to contribute to the development of an oriental medicine assessment tool for headache.

• Journal of Sasang Constitutional Medicine
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• v.32 no.4
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• pp.45-64
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• 2020

Purpose This study was to develop and study 'Diagnostic Index for the Ordinary Symptom of Soyangin'. Methods The main diagnosis and evaluation index symptoms of Soyangin were extracted based on 『Donguisusebowon』 and Clinical Practice Guidelines for Sasang Constitutional Medicine Symptomatology; CPG for soyangin. The selected ordinary symptoms were divided into 4 categories such as Exterior-Cold ordinary symptom (表寒素證), Exterior-Disease unfavorable's ordinary symptom (表病逆證素證), Interior-Heat ordinary symptom (裏熱素證), Interior-Disease unfavorable's ordinary symptom (裏病逆證素證) of Soyangin and translated into Korean. And the inclusion, importance and translation validity of major diagnosis and assessment indicators of Soyangin were surveyed online by a group of Sasang constitutional experts. Results & Conclusions 29 ordinary symptoms and pathological mechanism were selected from references and translated into 51 Korean symptoms. After inclusion yes or no survey by expert group, 45 symptoms were selected. The importance survey showed that 'Have a soft stool' of Exterior-Cold ordinary symptom indication, '(If you're stressed, if you're not in good health) Have a soft stool or diarrhea' of Exterior-Disease unfavorable's ordinary symptom, 'The feces harden easily' of Interior-Heat ordinary symptom and '(If you're stressed, if you're not in good health) Have an upset stomach' of Interior-Disease unfavorable's ordinary symptom were the most important. Finally, [Diagnostic Index for the Ordinary Symptom of Soyangin] was completed after survey of translation validity, reflection of individual opinions by the expert committee, and application of weighted value calculated from the importance survey.

• Korean Medical Education Review
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• v.20 no.3
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• pp.141-149
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• 2018

This study examined doctors' images represented in the Korean press to identify overall public perceptions of doctors and to suggest areas for improvement to enhance their image. All news reports published in the two major Korean daily newspapers between years 2011 and 2015 related to doctors and the practice of medicine were searched and collected. The news reports were categorized into the five competency domains in the Korean doctor's role (i.e., patient care, communication and cooperation, social accountability, professionalism, and education and research). Each news item was coded as being either positive or negative and was given a score regarding the extent to which positive or negative image that it represents of doctors using the Doctor Image Scale (DIS) score. A total of 314 news reports were collected, a majority of which were on patient care (36%), professionalism (33%), and social accountability (23%). Positive stories slightly outnumbered negative ones (56% vs. 44%). The largest number of positive news reports was in patient care (n=82); negative news reports most frequently appeared in professionalism (n=99) and patient care (n=32). The total DIS score was also positive (+28): the highest positive DIS score was in social accountability (+164); the highest negative DIS score was obtained in professionalism (-226). This study revealed overall positive portrayals of doctors in the Korean press, yet doctors need to better comply with regulations and ethical guidelines and enhance their medical knowledge and clinical skills and to improve their image.

• Imaging Science in Dentistry
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• v.53 no.3
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• pp.193-198
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• 2023

Purpose: Artificial intelligence (AI) is poised to play a major role in medical diagnostics. Periodontal disease is one of the most common oral diseases. The early diagnosis of periodontal disease is essential for effective treatment and a favorable prognosis. This study aimed to assess the effectiveness of AI in diagnosing periodontal bone loss through radiographic analysis. Materials and Methods: A literature search involving 5 databases (PubMed, ScienceDirect, Scopus, Health and Medical Collection, Dentistry and Oral Sciences) was carried out. A specific combination of keywords was used to obtain the articles. The PRISMA guidelines were used to filter eligible articles. The study design, sample size, type of AI software, and the results of each eligible study were analyzed. The CASP diagnostic study checklist was used to evaluate the evidence strength score. Results: Seven articles were eligible for review according to the PRISMA guidelines. Out of the 7 eligible studies, 4 had strong CASP evidence strength scores (7-8/9). The remaining studies had intermediate CASP evidence strength scores (3.5-6.5/9). The highest area under the curve among the reported studies was 94%, the highest F1 score was 91%, and the highest specificity and sensitivity were 98.1% and 94%, respectively. Conclusion: AI-based detection of periodontal bone loss using radiographs is an efficient method. However, more clinical studies need to be conducted before this method is introduced into routine dental practice.

• Journal of Oriental Neuropsychiatry
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• v.29 no.3
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• pp.135-144
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• 2018

Objectives: The purpose of this study was to analyze the medical cost for patients with vertigo and to examine associations between chronic vertigo and mental disorder using 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: We analyzed sociodemographic characteristics, medical cost and medical care use pattern for vertigo patients. We used hierarchical multiple logistic regression analysis to examine odds ratio between chronic vertigo and mental disorder. Results: A total of 46,502 people and 118,504 claims data were identified for vertigo cases. Characteristics of vertigo patients have significant differences on proportion of female patients (68.36%), patients' average age (54.98) and proportion of medical assistance (5.76%) compared with non-vertigo patients. Results revealed that Korean medicine are one of frequent methods among total treatments for vertigo patients. Total days of medical care and total costs are 2.78 days and 111,362 won, respectively, and days for outpatients in Korean medical care (mean: 2.26 days) are more than those (mean: 5.05 days) in Western medical care. There is significant difference relative to sex between acute vertigo and chronic vertigo. The odds ratio between chronic vertigo and mental disorder is estimated as 1.34, that means risk of becoming chronic is 34% higher for vertigo patients with mental disorder. Conclusions: This study assessed socio-demographic characteristics, medical care use and expenses related to vertigo, and estimated associations between chronic vertigo and mental disorder. Findings provide a basis for economic evaluation studies on vertigo patients and development of clinical practice guidelines for vertigo patients with mental disorder.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.2
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• pp.255-264
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• 2006

Purpose: This study was carried out to understand the in-patients' experiences related on informed consent for examination, treatment or surgery. Method: The study was conducted with 578 patients who were admitted to the departments of internal medicine and surgery for examination, treatment or surgery requiring informed consent from November 1 to 30, 2004 at three general hospitals in Daegu, Busan and Gyeongsangbuk-do. The data was analyzed by using SPSS 11.5 for Windows. Results: Although the one who explains during the process of informed consent should be doctors, 6.6% was informed by nurses or others. In addition, the majority has been told for complications and risk while relatively fewer patients were informed for necessity, method and costs of the procedure, and no one ever heard of other alternatives or the right to terminate the procedure at any time. While 40% of patients were not the final decision-makers of examination, treatment or surgery, 11.9% of patients answered their opinions were not considered during the final decision-making process. Conclusion: The study suggest that the ethically appropriate informed consent has not been achieved in the clinical practice, and therefore it is necessary to develop the specific behavioral guidelines and nursing ethics education program for nurses in order to settle down the desirable informed consent at the dimension of nursing management.

• Journal of Chest Surgery
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• v.56 no.4
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• pp.255-261
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• 2023

Background: The surgical threshold for bicuspid aortic valve (BAV)-related aortopathy is a matter of debate due to its uncertain etiology and prognosis. This study investigated the prognosis of unrepaired BAV aortopathy in patients undergoing surgical aortic valve replacement (SAVR). Methods: We retrospectively analyzed data from 720 patients (age, 60.8±11.5 years; 246 women) who underwent SAVR for BAV disease without aortic repair between 2005 and 2020 at Asan Medical Center. The clinical endpoints were defined as occurrences of sudden death, aortic dissection or rupture, and elective aortic repair. To estimate postoperative changes in the dimensions of the unrepaired aorta, the individual annual aortic expansion rate was calculated. Multiple linear regression models were used to evaluate the risk of aortic expansion. Results: The mean ascending aortic diameter was 39.5±4.6 mm, and 299 patients (41.5%) had a baseline ascending aorta diameter >40 mm. During 70.0±68.3 months of follow-up, the mean annual aortic expansion rate was 0.39±1.96 mm/yr, no aortic dissection or rupture was observed, and sudden deaths were reported in 12 patients (0.34% per person-year). Linear regression analysis revealed no significant correlation between the baseline ascending aortic diameter and postoperative aortic expansion (R²=0.004, β=-0.84, p=0.082). Conclusion: In selected patients undergoing SAVR for a BAV (<55 mm), the risk of adverse aortic events was very low. As this observation contradicts current practice guidelines advocating for proactive aortic replacement in dilated ascending aortas measuring >45 mm, the study results need further validation by studies involving larger populations or randomized controlled trials.

• Journal of Pharmacopuncture
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• v.18 no.3
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• pp.42-48
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• 2015

Objectives: The aim of the study is to investigate both the single-dose intramuscular injection toxicity and the approximate lethal dose of water-soluble Carthami-flos and Cervi cornu parvum pharmacopuncture (WCFC) in male and female Sprague-Dawley (SD) rats. Methods: The study was conducted at Biotoxtech Co. according to the Good Laboratory Practice (GLP) regulation and the toxicity test guidelines of the Ministry of Food and Drug Safety (MFDS) after approval of the Institutional Animal Care and Use Committee. Dosages for the control, high dose, middle dose and low dose groups were 0.5 mL/animal of saline and 0.5, 0.25 and 0.125 mL/animal of WCFC, respectively. WCFC was injected into the muscle of the left femoral region by using a disposable syringe (1 mL, 26 gauge). The general symptoms and mortality were observed 30 minutes, 1, 2, 4, and 6 hours after the first injection and then daily for 14 days after the injection. The body weights of the SD rats were measured on the day of the injection (before injection) and on the third, seventh, and fourteenth days after the injection. Serum biochemical and hematologic tests, necropsy examinations, and histopathologic examinations at the injection site were performed after the observation period. Results: No deaths, abnormal clinical symptoms, or significant weight changes were observed in either male or female SD rats in the control or the test (0.125, 0.25, and 0.5 mL/animal) groups during the observation period. No significant differences in hematology and serum biochemistry and no macroscopic abnormalities at necropsy were found. No abnormal reactions at injection sites were noted on the topical tolerance tests. Conclusion: The results of this single-dose toxicity study show that WCFC is safe, its lethal doses in male and female SD rats being estimated to be higher than 0.5 mL/animal.